Provider Demographics
NPI:1548252281
Name:DELAGARZA, VINCENT WALTER (MD)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:WALTER
Last Name:DELAGARZA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:6003 WOODLAND BLUFF RD
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-9403
Mailing Address - Country:US
Mailing Address - Phone:304-598-0695
Mailing Address - Fax:304-598-6917
Practice Address - Street 1:1 STADIUM DRIVE
Practice Address - Street 2:HEALTH SCIENCES CENTER
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505
Practice Address - Country:US
Practice Address - Phone:304-598-6900
Practice Address - Fax:304-598-6917
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-18
Last Update Date:2011-10-04
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Provider Licenses
StateLicense IDTaxonomies
WV17094207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine